Compendium of Animal Rabies Prevention and Control, 2007 National Association of State Public Health Veterinarians, Inc

Morbidity and Mortality Weekly Report

Recommendations and Reports April 6, 2007 / Vol. 56 / No. RR-3

Compendium of Animal Rabies Prevention and Control, 2007 National Association of State Public Health Veterinarians, Inc.

department of health and human services Centers for Disease Control and Prevention MMWR

CONTENTS The MMWR series of publications is published by the Coordinating Center for Health Information and Service, Centers for Disease Part I: Rabies Prevention and Control ...... 1 Control and Prevention (CDC), U.S. Department of Health and Part II: Recommendations for Parenteral Rabies Human Services, Atlanta, GA 30333. Vaccination Procedures ...... 6 Suggested Citation: Centers for Disease Control and Prevention. [Title]. MMWR 2007;56(No. RR-#):[inclusive page numbers]. Part III: Rabies Vaccines Licensed and Marketed Centers for Disease Control and Prevention in the United States, 2007 ...... 7 Julie L. Gerberding, MD, MPH References...... 8 Director Tanja Popovic, MD, PhD (Acting) Chief Science Officer James W. Stephens, PhD (Acting) Associate Director for Science Steven L. Solomon, MD Director, Coordinating Center for Health Information and Service Jay M. Bernhardt, PhD, MPH Director, National Center for Health Marketing B. Kathleen Skipper, MA (Acting) Director, Division of Health Information Dissemination (Proposed)

Editorial and Production Staff Frederic E. Shaw, MD, JD Editor, MMWR Series Suzanne M. Hewitt, MPA Managing Editor, MMWR Series Teresa F. Rutledge Lead Technical Writer-Editor Patricia A. McGee Project Editor Beverly J. Holland Lead Visual Information Specialist Lynda G. Cupell Malbea A. LaPete Visual Information Specialists Quang M. Doan, MBA Erica R. Shaver Information Technology Specialists

Editorial Board William L. Roper, MD, MPH, Chapel Hill, NC, Chairman Virginia A. Caine, MD, Indianapolis, IN David W. Fleming, MD, Seattle, WA William E. Halperin, MD, DrPH, MPH, Newark, NJ Margaret A. Hamburg, MD, Washington, DC King K. Holmes, MD, PhD, Seattle, WA Deborah Holtzman, PhD, Atlanta, GA John K. Iglehart, Bethesda, MD Dennis G. Maki, MD, Madison, WI Sue Mallonee, MPH, Oklahoma City, OK Stanley A. Plotkin, MD, Doylestown, PA Patricia Quinlisk, MD, MPH, Des Moines, IA Patrick L. Remington, MD, MPH, Madison, WI Barbara K. Rimer, DrPH, Chapel Hill, NC John V. Rullan, MD, MPH, San Juan, PR Anne Schuchat, MD, Atlanta, GA This report is being published as a courtesy to the National Association Dixie E. Snider, MD, MPH, Atlanta, GA of State Public Health Veterinarians, Inc., and to the MMWR John W. Ward, MD, Atlanta, GA readership. Vol. 56 / RR-3 Recommendations and Reports 1

Compendium of Animal Rabies Prevention and Control, 2007* National Association of State Public Health Veterinarians, Inc. (NASPHV) Rabies is a fatal viral zoonosis and a serious public health problem (1). The disease is an acute progressive encephalitis caused by a lyssavirus. Multiple viral variants are maintained in wild mammal populations in the United States, but all mammals are believed to be susceptible to the disease. For purposes of this document, use of the term “animal” refers to mammals. The recommendations in this compendium serve as a basis for animal rabies-prevention and -control programs throughout the United States and facilitate standardization of procedures among jurisdictions, thereby contributing to an effective national rabies-control program. This document is reviewed annually and revised as necessary. These recommendations do not supersede state and local laws or requirements. Principles of rabies prevention and control are detailed in Part I; recommendations for parenteral vaccination procedures are presented in Part II, and all animal rabies vaccines licensed by the U.S. Department of Agriculture (USDA) and marketed in the United States are listed in Part III.

Part I: Rabies Prevention 3. Human Rabies Prevention. Rabies in humans can be and Control prevented either by eliminating exposures to rabid animals or by providing exposed persons with prompt A. Principles of Rabies Prevention and Control. local treatment of wounds combined with the adminis- 1. Rabies Exposure. Rabies is transmitted only when the tration of human rabies immune globulin and vaccine. virus is introduced into bite wounds, open cuts in skin, The rationale for recommending preexposure and or onto mucous membranes from saliva or other postexposure rabies prophylaxis and details of their potentially infectious material such as neural tissue (2). administration can be found in the current recommen- Questions regarding possible exposures should be dations of the Advisory Committee on Immunization directed promptly to state or local public health Practices (ACIP) (2). These recommendations, along authorities. with information concerning the current local and 2. Public Health Education. Essential components of regional epidemiology of animal rabies and the avail- rabies prevention and control include ongoing public health ability of human rabies biologics, are available from state education, responsible pet ownership, routine veterinary health departments. care, and professional continuing education. The major- 4. Domestic Animals. Local governments should initiate ity of animal and human exposures to rabies can be pre- and maintain effective programs to ensure vaccination vented by raising awareness concerning rabies transmission of all dogs, cats, and ferrets and to remove strays and routes; avoiding contact with wildlife; and following unwanted animals. Such procedures in the United States appropriate veterinary care. Prompt recognition and have reduced laboratory-confirmed cases of rabies in reporting of possible exposures to medical professionals dogs from 6,949 in 1947 to 76 in 2005 (3). Because and local public health authorities are critical. more rabies cases are reported annually involving cats (269 in 2005) than dogs, vaccination of cats should be * The NASPHV Committee: Ben Sun, DVM, MPVM, Chair; Michael required (3). Animal shelters and animal-control Auslander, DVM, MSPH; Lisa Conti, DVM, MPH; Paul Ettestad, DVM, MS; Mira J. Leslie, DVM, MPH; Faye E. Sorhage, VMD, MPH. authorities should establish policies to ensure that Consultants to the Committee: Carl Armstrong, MD, Council of State adopted animals are vaccinated against rabies. The rec- and Territorial Epidemiologists (CSTE); Donna M. Gatewood, DVM, MS, ommended vaccination procedures and the licensed U.S. Department of Agriculture Center for Veterinary Biologics; Suzanne R. Jenkins, VMD, MPH; Lorraine Moule, National Animal Control animal vaccines are specified in Parts II and III of this Association (NACA); Charles E. Rupprecht, VMD, PhD, MS, CDC; Greg compendium, respectively. Pruitt, MEd, BS, Animal Health Institute; John Schiltz, DVM, American Veterinary Medical Association (AVMA); Dennis Slate, PhD, U.S. 5. Rabies in Vaccinated Animals. Rabies is rare in vacci- Department of Agriculture Wildlife Services; Charles V. Trimarchi, MS, nated animals (4). If such an event is suspected, it should American Public Health Laboratory Association (APHL); Burton Wilcke, be reported to state public health officials; the vaccine Jr., PhD, American Public Health Association (APHA). This compendium has been endorsed by APHA; AVMA; Association of Public Health manufacturer; and USDA, Animal and Plant Health Laboratories, CSTE; and NACA. Inspection Service, Center for Veterinary Biologics Corresponding preparer: Ben Sun, DVM, MPVM, State Public Health (Internet: http://www.aphis.usda.gov/vs/cvb/html/ Veterinarian, California Department of Health Services, Veterinary Public Health Section, MS 7308, P.O. Box 997413, Sacramento, CA 95899-7413. adverseeventreport.html; telephone: 800-752-6255; or Telephone: 916-552-9740; Fax: 916-552-9725; E-mail: [email protected]. e-mail: [email protected]). The laboratory diagnosis 2 MMWR April 6, 2007

should be confirmed, and the virus should be charac- protection because other immunologic factors also play terized by a rabies reference laboratory. A thorough epi- a role in preventing rabies, and the ability to measure demiologic investigation should be conducted. and interpret those other factors are not well developed. 6. Rabies in Wildlife. The control of rabies among wild- Therefore, evidence of circulating rabies virus antibod- life reservoirs is difficult (5). Vaccination of free- ies should not be used as a substitute for current vacci- ranging wildlife or selective population reduction might nation in managing rabies exposures or determining the be useful in certain situations, but the success of such need for booster vaccinations in animals (9–11). procedures depends on the circumstances surrounding B. Prevention and Control Methods in Domestic and each rabies outbreak (see Part I.C.). Because of the risk Confined Animals. of rabies in wild animals (especially raccoons, skunks, 1. Preexposure Vaccination and Management. Parenteral coyotes, foxes, and bats), AVMA, CSTE, NACA, and animal rabies vaccines should be administered only by NASPHV strongly recommend the enactment and or under the direct supervision of a veterinarian. enforcement of state laws prohibiting their importa- Rabies vaccinations also may be administered under the tion, distribution, and translocation. supervision of a veterinarian to animals held in animal- 7. Rabies Surveillance. Laboratory-based rabies surveil- control shelters before release. Any veterinarian signing lance and variant typing are essential components of a rabies certificate must ensure that the person admin- rabies-prevention and -control programs. Accurate and istering vaccine is identified on the certificate and is timely information is necessary to guide human appropriately trained in vaccine storage, handling, postexposure prophylaxis decisions, determine the man- administration, and in the management of adverse agement of potentially exposed animals, aid in emerg- events. This practice ensures that a qualified and ing pathogen discovery, describe the epidemiology of responsible person can be held accountable for prop- the disease, and assess the need for and effectiveness of erly vaccinating the animal. vaccination programs for wildlife. Within 28 days after initial vaccination, a peak 8. Rabies Diagnosis. Rabies testing should be performed rabies virus antibody titer is reached, and the animal in accordance with the established national standard- can be considered immunized. An animal is considered ized protocol for rabies testing (http://www.cdc.gov/ currently vaccinated and immunized if the initial vac- ncidod/dvrd/rabies/Professional/publications/DFA_ cination was administered at least 28 days previously or diagnosis/ DFA_protocol-b.htm) by a qualified labo- booster vaccinations have been administered in accor- ratory that has been designated by the local or state dance with this compendium. health department (6,7). Euthanasia should be accom- Regardless of the age of the animal at initial vaccina- plished in such a way as to maintain the integrity of the tion, a booster vaccination should be administered brain so that the laboratory can recognize the anatomi- 1 year later (see Parts II and III for vaccines and proce- cal parts (8). Except in the case of very small animals, dures). No laboratory or epidemiologic data exist to such as bats, only the head or brain (including brain support the annual or biennial administration of 3- or stem) should be submitted to the laboratory. To facili- 4-year vaccines following the initial series. Because a tate laboratory processing and prevent a delay in test- rapid anamnestic response is expected, an animal is con- ing, any animal or animal specimen being submitted sidered currently vaccinated immediately after a booster for testing should preferably be stored and shipped vaccination. under refrigeration and not be frozen. Chemical fixa- a. Dogs, Cats, and Ferrets. All dogs, cats, and ferrets tion of tissues should be avoided to prevent substantial should be vaccinated and revaccinated against rabies testing delays and because it might preclude reliable test- in accordance with Part III of this compendium. If a ing. Questions regarding testing of fixed tissues should previously vaccinated animal is overdue for a booster, be directed to the local rabies laboratory or public health it should be revaccinated. Immediately following the department. booster, the animal is considered currently vaccinated 9. Rabies Serology. Certain “rabies-free” jurisdictions and should be placed on a vaccination schedule might require evidence of vaccination and rabies virus according to the labeled duration of the vaccine used. antibodies for animal importation purposes. Rabies b. Livestock. Consideration should be given to vacci- virus antibody titers are indicative of a response to vac- nating livestock that are particularly valuable. Ani- cine or infection. Titers do not directly correlate with mals that have frequent contact with humans (e.g., Vol. 56 / RR-3 Recommendations and Reports 3

in petting zoos, fairs, and other public exhibitions) Division of Global Migration and Quarantine, CDC and horses traveling interstate should be currently (telephone: 404-639-3441). vaccinated against rabies (12,13). Federal regulations alone are insufficient to pre- c. Confined Animals. vent the introduction of rabid animals into the United 1.) Wild. No parenteral rabies vaccines are licensed States (18,19). All imported dogs and cats are sub- for use in wild animals or hybrids (i.e., the off- ject to state and local laws governing rabies and should spring of wild animals crossbred to domestic ani- be currently vaccinated against rabies in accordance mals). The AVMA has recommended that wild with this compendium. Failure to comply with state animals or hybrids should not be kept as pets or local requirements should be referred to the (14–17). appropriate state or local official. 2.) Maintained in Exhibits and in Zoological b. Interstate. Before interstate movement (including Parks. Captive mammals that are not completely commonwealths and territories), dogs, cats, ferrets, excluded from all contact with rabies vectors can and horses should be currently vaccinated against become infected. Moreover, wild animals might rabies in accordance with this compendium’s recom- be incubating rabies when initially captured; mendations (see Part I.B.1.). Animals in transit therefore, wild-caught animals susceptible to should be accompanied by a valid NASPHV Form rabies should be quarantined for a minimum of 51, Rabies Vaccination Certificate (http://www.nasp 6 months. Employees who work with animals at hv.org). When an interstate health certificate or cer- exhibits and in zoological parks should receive tificate of veterinary inspection is required, it should preexposure rabies vaccination. The use of pre- contain the same rabies vaccination information as or postexposure rabies vaccinations for handlers Form 51. who work with animals at such facilities might c. Areas with Dog-to-Dog Rabies Transmission. reduce the need for euthanasia of captive animals Canine rabies virus variants have been eliminated that expose handlers. Carnivores and bats should in the United States (3). Rabid dogs have been be housed in a manner that precludes direct con- introduced into the continental United States from tact with the public (12). areas with dog-to-dog rabies transmission (18,19). 2. Stray Animals. Stray dogs, cats, and ferrets should be This practice poses a risk for introducing canine- removed from the community. Local health departments transmitted rabies to areas in the United States where and animal-control officials can enforce the removal of it does not exist. The importation of dogs for the strays more effectively if owned animals have identifi- purposes of adoption or sale from areas with dog-to- cation and are confined or kept on leash. Strays should dog rabies transmission should be prohibited. be impounded for at least 3 business days to determine 4. Adjunct Procedures. Methods or procedures that en- if human exposure to rabies has occurred and to give hance rabies control include the following: owners sufficient time to reclaim animals. a. Identification. Dogs, cats, and ferrets should be iden- 3. Importation and Interstate Movement of Animals. tified (e.g., by metal or plastic tags or microchips) to a. International. CDC regulates the importation of allow for verification of rabies vaccination status. dogs and cats into the United States. Importers of b. Licensure. Registration or licensure of all dogs, cats, dogs must comply with rabies vaccination require- and ferrets can be used to aid in rabies control. A fee ments (42 CFR, Part 71.51[c] [http://www.cdc.gov/ is frequently charged for such licensure, and revenues ncidod/dq/animal.htm]) and complete CDC form collected are used to maintain rabies- or animal- 75.37 (http://www.cdc.gov/ncidod/dq/pdf/animal/ control programs. Evidence of current vaccination dog_quarantine_notice_08-04-06-cdc7537.pdf). is an essential prerequisite to licensure. The appropriate health official of the state of desti- c. Canvassing. House-to-house canvassing by animal- nation should be notified within 72 hours of the ar- control officials facilitates enforcement of vaccina- rival into the jurisdiction of any imported dog tion and licensure requirements. required to be placed in confinement under the CDC d. Citations. Citations are legal summonses issued to regulation. Failure to comply with these confinement owners for violations, including failure to vaccinate requirements should be promptly reported to the or license their animals. The authority for officers to 4 MMWR April 6, 2007

issue citations should be an integral part of each Handling and consumption of tissues from animal-control program. exposed animals might carry a risk for rabies trans- e. Animal Control. All communities should incorpo- mission. The risk depends in part on the site(s) of rate stray animal control, leash laws, animal bite preexposure, amount of virus present, severity of vention, and training of personnel in their programs. wounds, and whether sufficient contaminated tissue f. Public Education. All communities should incor- is later excised. If an exposed animal is to be slaugh- porate educational programs that cover responsible tered for consumption, it should be done immedi- pet ownership, bite prevention, and appropriate vet- ately after exposure. Barrier precautions should be erinary care. used by persons handling the animal, and all tissues 5. Postexposure Management. This section refers to any should be cooked thoroughly. Historically, federal animal exposed (see Part I.A.1.) to a confirmed or sus- guidelines for meat inspectors have required that any pected rabid animal. Wild, mammalian carnivores or animal known to have been exposed to rabies within bats that are not available for testing should be regarded 8 months be rejected for slaughter. USDA Food and as rabid animals. Inspection Service (FSIS) meat inspectors should be a. Dogs, Cats, and Ferrets. Unvaccinated dogs, cats, notified if such exposures occur in food animals and ferrets exposed to a rabid animal should be before slaughter. euthanized immediately. If the owner is unwilling to In infected animals, rabies virus might be widely have this done, the animal should be placed in strict distributed in tissues (21). Tissues and products from isolation for 6 months. Rabies vaccine should be a rabid animal should not be used for human or ani- administered to the animal upon entry into isola- mal consumption (22). However, pasteurization tem- tion or 1 month before release to comply with peratures will inactivate rabies virus; therefore, preexposure vaccination recommendations (see Part drinking pasteurized milk or eating thoroughly I.B.1.a.). No USDA biologics are licensed for cooked animal products does not constitute a rabies postexposure prophylaxis of previously unvaccinated exposure. domestic animals, and evidence exists that the use of Multiple rabid animals in a herd or herbivore- vaccine alone will not reliably prevent the disease in to-herbivore transmission is uncommon; therefore, these animals (20). Animals with expired vaccina- restricting the rest of the herd if a single animal has tions need to be evaluated on a case-by-case basis. been exposed to or infected by rabies is usually not Dogs, cats, and ferrets that are currently vaccinated necessary. should be revaccinated immediately, kept under the c. Other Animals. Other mammals exposed to a rabid owner’s control, and observed for 45 days. Any ill- animal should be euthanized immediately. Animals ness in an isolated or confined animal should be maintained in USDA-licensed research facilities or reported immediately to the local health department. accredited zoological parks should be evaluated on a If signs suggestive of rabies develop, the animal should case-by-case basis. be euthanized and the head shipped for testing as 6. Management of Animals that Bite Humans. described in Part I.A.8. a. Dogs, Cats, and Ferrets. Rabies virus might be b. Livestock. All species of livestock are susceptible to excreted in the saliva of infected dogs, cats, and fer- rabies; cattle and horses are the most frequently rets during illness and/or for only a few days before infected (3). Livestock exposed to a rabid animal and illness or death (23–25). A healthy dog, cat, or ferret currently vaccinated with a vaccine approved by that bites a person should be confined and observed USDA for that species should be revaccinated daily for 10 days (26); administration of rabies vac- immediately and observed for 45 days. Unvaccinated cine to the animal is not recommended during the livestock should be euthanized immediately. If the ani- observation period to avoid confusing signs of rabies mal is not euthanized, it should be kept under close with possible side effects of vaccination. Animals in observation for 6 months. Any illness in an animal confinement should be evaluated by a veterinarian under observation should be reported immediately to at the first sign of illness. Any illness in the animal the local health department. If signs suggestive of should be reported immediately to the local health rabies develop, the animal should be euthanized and department. If signs suggestive of rabies develop, the the head shipped for testing as described in Part I.A.8. animal should be euthanized and the head shipped Vol. 56 / RR-3 Recommendations and Reports 5

for testing as described in Part I.A.8. Any stray or d. Ensure that all animals have a unique identifier. unwanted dog, cat, or ferret that bites a person may e. Administer a rabies vaccination to all dogs, cats, and be euthanized immediately and the head submitted ferrets unless reliable proof of vaccination exists. for rabies examination. f. Adopt minimum standards for animal caretakers that b. Other Biting Animals. Other biting animals that include personal protective equipment, previous might have exposed a person to rabies should be rabies vaccination, and appropriate training in ani- reported immediately to the local health department. mal handling (see Part I.C.). Management of animals other than dogs, cats, and g. Maintain documentation of animal disposition and ferrets depends on the species, the circumstances of location (e.g., returned to owner, died or euthanized, the bite, the epidemiology of rabies in the area, the adopted, relocated to another shelter, address of new biting animal’s history, current health status, and the location). animal’s potential for exposure to rabies. Previous h. Provide facilities to confine and observe animals vaccination of these animals might not preclude the involved in exposures (see Part I.A.1.). necessity for euthanasia and testing. i. Report human exposures to appropriate public health 7. Outbreak Prevention and Control. The emergence authorities (see Part I.B.6.). of new rabies virus variants and the introduction of C. Prevention and Control Methods Related to Wildlife. nonindigenous viruses pose a substantial risk to humans, The public should be warned not to handle or feed wild domestic animals, and wildlife (27–34). In such situa- mammals. Wild mammals and hybrids that bite or other- tions, the public health response should be rapid and wise expose persons, pets, or livestock should be consid- comprehensive and should include the following ered for euthanasia and rabies examination. A person bitten measures: by any wild mammal should immediately report the inci- a. Characterize the virus at a national or regional refer- dent to a physician who can evaluate the need for ence laboratory. postexposure prophylaxis (2). b. Identify and control the source of the introduction. Translocation by humans of infected wildlife has con- c. Enhance laboratory-based surveillance in wild and tributed to the spread of rabies (28–32); therefore, the domestic animals. human translocation of known terrestrial rabies reservoir d. Increase animal rabies vaccination rates. species should be prohibited. Whereas state-regulated wild- e. Restrict the movement of animals at risk. life rehabilitators and nuisance wildlife-control operators f. Evaluate the need for vector population reduction. might play a role in a comprehensive rabies-control pro- g. Coordinate a multi-agency response. gram, minimum standards for persons who handle wild h. Provide public and professional outreach and education. mammals should include rabies vaccination, appropriate 8. Disaster Response. Animals might be displaced dur- training, and continuing education. ing and after manmade or natural disasters, and they 1. Carnivores. The use of licensed oral vaccines for the might require emergency sheltering (http://www.bt. mass vaccination of free-ranging wildlife should be con- cdc.gov/disasters/hurricanes/katrina/petshelters.asp, sidered in selected situations, with the approval of the http://www.hsus.org/disaster, and http://www.avma. state agency responsible for animal rabies control (5,36). org/disaster/default.asp) (35). Animal rabies vaccina- The distribution of oral rabies vaccine should be based tion and exposure histories often are not available for on scientific assessments of the target species and fol- displaced animals, and disaster response can create situ- lowed by timely and appropriate analysis of surveillance ations in which animal caretakers might lack appropri- data; such results should be provided to all stakehold- ate training and previous vaccination. In such situations, ers. In addition, parenteral vaccination (trap-vaccinate- the following rabies-prevention and -control measures release) of wildlife rabies reservoirs can be integrated should be used to reduce the risk for rabies transmis- into coordinated oral rabies vaccination programs to sion and the need for human postexposure prophylaxis. enhance their effectiveness. Long-term, widespread pro- a. Coordinate relief efforts of persons and organizations grams for trapping or poisoning wildlife are not effec- with the local emergency operations center before tive in reducing wildlife rabies reservoirs on a statewide deployment. basis. However, limited population control in high- b. Examine each animal for signs of rabies at a triage site. contact areas (e.g., picnic grounds, camps, and subur- c. Isolate animals exhibiting signs of rabies, pending ban areas) might be indicated for the removal of selected evaluation by a veterinarian. high-risk species of wildlife (5). State agriculture, pub- 6 MMWR April 6, 2007

lic health, and wildlife agencies should be consulted for exist to support the annual or biennial administration of planning, coordination, and evaluation of vaccination 3- or 4-year vaccines following the initial series. or population-reduction programs. C. Adverse Events. Currently, no epidemiologic association 2. Bats. Since the 1950s, indigenous rabid bats have been exists between any licensed vaccine and adverse events, reported from every state except Hawaii and have caused including vaccine failure (47,48). Adverse events should rabies in at least 40 humans in the United States be reported to the vaccine manufacturer and to USDA, (37–42). Bats should be excluded from houses, public Animal and Plant Health Inspection Service, Center for buildings, and adjacent structures to prevent direct Veterinary Biologics (Internet: http://www.aphis.usda. association with humans (43,44). Such structures should gov/vs/cvb/html/adverseeventreport.html; telephone: then be made bat-proof by sealing entrances used by 800-752-6255; or e-mail: [email protected]). bats. Controlling rabies in bats through programs D. Wildlife and Hybrid Animal Vaccination. The safety and designed to reduce bat populations is neither feasible efficacy of parenteral rabies vaccination of wildlife and nor desirable. hybrids have not been established, and no rabies vaccines are licensed for these animals. Parenteral vaccination (trap- vaccinate-release) of wildlife rabies reservoirs can be inte- Part II: Recommendations grated into coordinated oral rabies vaccination programs, for Parenteral Rabies as described in Part I.C.1., to enhance their effectiveness. Vaccination Procedures Zoos or research institutions may establish vaccination programs to protect valuable animals, but these should not A. Vaccine Administration. All animal rabies vaccines should replace appropriate public health activities to protect be restricted to use by or under the direct supervision of a humans (9). veterinarian (45), except as recommended in Part I.B.1. E. Accidental Human Exposure to Vaccine. Human expo- All vaccines must be administered in accordance with the sure to parenteral animal rabies vaccines listed in Part III specifications of the product label or package insert. does not constitute a risk for rabies virus infection. B. Vaccine Selections. Part III lists all vaccines licensed by Human exposure to vaccinia-vectored oral rabies vaccines USDA and marketed in the United States at the time of should be reported to state health officials (49). publication. New vaccine approvals or changes in label F. Rabies Certificate. All agencies and veterinarians should specifications made subsequent to publication should be use NASPHV Form 51 (revised 2007), Rabies Vaccina- added to this list. Any of the listed vaccines can be used for tion Certificate, or an equivalent, which can be obtained revaccination, even if the product is not the same as previ- from vaccine manufacturers, NASPHV (http://www. ously administered. Vaccines used in state and local rabies- nasphv.org), or CDC (http://www.cdc.gov/ncidod/dvrd/ control programs should have at least a 3-year duration of rabies/professional/professi.htm). The form must be com- immunity. This constitutes the most effective method of pleted in full and signed by the administering or supervis- increasing the proportion of immunized dogs and cats in ing veterinarian. Computer-generated forms containing the any population (46). No laboratory or epidemiologic data same information are acceptable. Vol. 56 / RR-3 Recommendations and Reports 7

Part III: Rabies vaccines licensed and marketed in the United States, 2007 For Dosage Age at primary Booster Route of Product name Produced by Marketed by use in (mL) vaccination* recommended inoculation A) MONOVALENT (Inactivated) DEFENSOR 1 Pfizer, Inc. Pfizer, Inc. Dogs 1 3 mos† Annually IM§ or SC¶ License No. 189 Cats 1 3 mos Annually SC DEFENSOR 3 Pfizer, Inc. Pfizer, Inc. Dogs 1 3 mos 1 year later and triennially IM or License No. 189 Cats 1 3 mos 1 year later and triennially SC Sheep 2 3 mos Annually IM Cattle 3 3 mos Annually IM RABDOMUN Pfizer, Inc. Schering-Plough Dogs 1 3 mos 1 year later and triennially IM or License No. 189 Cats 1 3 mos 1 year later and triennially SC Sheep 2 3 mos Annually IM Cattle 3 3 mos Annually IM RABDOMUN 1 Pfizer, Inc. Schering-Plough Dogs 1 3 mos Annually IM or License No. 189 Cats 1 3 mos Annually SC RABVAC 1 Fort Dodge Animal Health Fort Dodge Animal Health Dogs 1 3 mos Annually IM or License No. 112 Cats 1 3 mos Annually IM RABVAC 3 Fort Dodge Animal Health Fort Dodge Animal Health Dogs 1 3 mos 1 year later and triennially IM or License No. 112 Cats 1 3 mos 1 year later and triennially IM or Horses 2 3 mos Annually IM RABVAC 3 TF Fort Dodge Animal Health Fort Dodge Animal Health Dogs 1 3 mos 1 year later and triennially IM or License No. 112 Cats 1 3 mos 1 year later and triennially IM or Horses 2 3 mos Annually IM PRORAB-1 Intervet, Inc. Intervet, Inc. Dogs 1 3 mos Annually IM or License No. 286 Cats 1 3 mos Annually IM or Sheep 2 3 mos Annually IM CONTINUUM RABIES Intervet, Inc. Intervet, Inc. Dogs 1 3 mos 1 year later and triennially SC License No. 286 Cats 1 3 mos 1 year later and quadrennially SC IMRAB 3 Merial, Inc. Merial, Inc. Dogs 1 3 mos 1 year later and triennially IM or License No. 298 Cats 1 3 mos 1 year later and triennially IM or Sheep 2 3 mos 1 year later and triennially IM or Cattle 2 3 mos Annually IM or Horses 2 3 mos Annually IM or Ferrets 1 3 mos Annually SC IMRAB 3 TF Merial, Inc. Merial, Inc. Dogs 1 3 mos 1 year later and triennially IM or License No. 298 Cats 1 3 mos 1 year IM or Ferrets 1 3 mos Annually SC IMRAB Large Animal Merial, Inc. Merial, Inc. Cattle 2 3 mos Annually IM or License No. 298 Horses 2 3 mos Annually IM or Sheep 2 3 mos 1 year later and triennially SC IMRAB 1 Merial, Inc. Merial, Inc. Dogs 1 3 mos Annually SC License No. 298 Cats 1 3 mos Annually SC IMRAB 1 TF Merial, Inc. Merial, Inc. Dogs 1 3 mos Annually SC License No. 298 Cats 1 3 mos Annually SC B) MONOVALENT (Rabies glycoprotein, live canary pox vector) PUREVAX Feline Rabies Merial, Inc. Merial, Inc. Cats 1 8 wks Annually SC License No. 298 C) COMBINATION (Inactivated rabies) Equine POTOMAVAC + IMRAB Merial, Inc. Merial, Inc. Horses 1 3 mos Annually IM License No. 298 CONTINUUM DAP-R Intervet, Inc. Intervet, Inc. Dogs 1 3 mos 1 year later and triennially SC License No. 286 CONTINUUM Feline HCP-R Intervet, Inc. Intervet, Inc. Cats 1 3 mos 1 year later and SC License No. 286 quadrennially** D) COMBINATION (Rabies glycoprotein, live canary pox vector) PUREVAX Feline 3/Rabies Merial, Inc. Merial, Inc. Cats 1 8 wks Annually SC License No. 298 PUREVAX Feline 4/Rabies Merial, Inc. Merial, Inc. Cats 1 8 wks Annually SC License No. 298 E) ORAL (Rabies glycoprotein, live vaccinia vector) — RESTRICTED TO USE IN STATE AND FEDERAL RABIES-CONTROL PROGRAMS RABORAL V-RG Merial, Inc. Merial, Inc. Raccoons N/A†† N/A As determined by local Oral License No. 298 Coyotes authorities * Minimum age (or older) and revaccinated 1 year later. † One month = 28 days. § Intramuscularly. ¶ Subcutaneously. ** Non-rabies fractions have a 3-year duration (see label). †† Not applicable. Rabies vaccine manufacturer contact information Manufacturer Fort Dodge Animal Health Intervet, Inc. Merial, Inc. Pfizer, Inc. Schering-Plough Corp. Phone number 800-533-8536 800-835-0541 888-637-4251 800-366-5288 800-521-5767 Internet address http://www.wyeth.com/ http://www.intervetusa.com http://us.merial.com http://www.pfizerah.com http://www.spah.com/usa divisions/fort_dodge.asp Note: ADVERSE EVENTS: Adverse events should be reported to the vaccine manufacturer and to the U.S. Department of Agriculture, Animal and Plant Health Inspection Service, Center for Veterinary Biologics (Internet: http://www.aphis.usda.gov/vs/cvb/html/adverseeventreport.html; telephone: 800-752-6255; or e-mail: [email protected]). 8 MMWR April 6, 2007

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